Rochester, NY (PRWEB) June 15, 2013
June 15 is World Elder Abuse Awareness Day. In honor of the day, Not Dead Yet, a national disability rights group, urges elder abuse professionals to speak out against legalization of assisted suicide.
“Most states reject assisted suicide,” says Diane Coleman, Not Dead Yet’s President and CEO. “Assisted suicide is legal in just three states. Oregon and Washington enacted their laws in 1997 and 2008. Last month, Vermont enacted its law.”
A major concern among disability groups is the risk of abuse of elders and people with disabilities. “The clearest explanation that I’ve heard about the problems with abuse in the context of assisted suicide come from elder law attorney, Margaret Dore,” says Coleman. “Margaret calls assisted suicide laws a ‘recipe for elder abuse.’ She has probably done more than anyone to connect the dots between what is known about elder abuse and the specific provisions of assisted suicide legislation.”
In a recent article about Vermont’s new law, Dore highlighted two elder abuse studies published by the Met Life Mature Market Institute. “In the first study, from 2009, the estimated annual financial loss by victims in the United States was $2.6 billion,” Dore noted. “In the second study, from 2011, the estimated loss was increased to $2.9 billion. Again, these are yearly figures. Elder abuse is a huge problem.”
Disability advocates are very concerned about the role of family members and other caregivers. Dore says, “The 2009 study also describes how perpetrators are often family members, some of whom feel themselves ‘entitled’ to the elder’s assets.” According to Dore, “The study describes how the abuse starts out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or coercing elders to sign over the deeds to their homes, change their wills, or liquidate their assets. The report also states that victims ‘may be murdered’ by perpetrators.”
Dore relates this to specific provisions in assisted suicide legislation. “With assisted suicide laws in Washington, Oregon and Vermont, perpetrators can instead take a ‘legal’ route, by getting an elder to agree to a lethal dose request. Once the lethal dose is issued by the pharmacy, there is no supervision over administration. Not even a witness is required. If the elder struggled, who would know?”
Proponents of assisted suicide claim that official reports from Oregon and Washington prove that assisted suicide is safe. According to Dore, however, these reports are a version of “Don’t Ask, Don’t Tell.” She says, “Required official forms and reports do not ask about or report on whether the patient consented at the time of death.”
“The official reports are not, however, useless,” says Dore. “They show that the majority of people who have died under the Oregon and Washington Acts have been well-educated. Typically, people with this attribute would be those with money, i.e., the middle class and above. The statistics also show that the majority of people dying have been age sixty-five or older. ‘Older people with money’ are a prime demographic for abuse.”
Some disability advocates believe that professionals in the field of elder abuse prevention have important knowledge to contribute to the assisted suicide debate. “So far, elder abuse professionals have not been very visible,” says Diane Coleman, “and that needs to change. Policy makers need a much deeper understanding of elder and disability abuse when they are weighing the pros and cons of assisted suicide legislation.”
A copy of the release in pdf format, including a summary and photo of Margaret Dore, is here. – Diane Coleman
Hopefully! Margaret Dore and other activists who try to protect the elderly/disabled against bad policies like “Assisted Suicide” will become aware that the policy of the 1991 Patient Self Determination Act is being circumvented by the hospitals in the majority of the United States as to both the CHOICE to LIVE and the CHOICE to DIE.
This is the WORST kind of ELDER ABUSE that goes undiscovered and unseen because there are no procedural protections in place to protect the autonomy of the elderly/disabled patients as to either the choice to live or the choice to die.
The Congress of the United States is aware of this problem and yet they do NOTHING and protect the status quo that protects the private profits in our for-profit health care system. Since both parties are complicit in producing this disgraceful state of affairs, we have silence and ongoing OVER TREATMENT for PROFIT, and UNDER TREATMENT, also for profit.
Under the radar passive euthanasia of the elderly for fiscal reasons is an ugly reality that should be exposed to save the soul and the moral fiber of our great Democratic Republic. .
I read a lot from bioethicists, “end of life” specialists, and others – almost all focus their energies on identifying “overtreatment” as one of the primary problems in health care for the elderly – both in terms of humane care and in terms of financial burden. In short there doesn’t seem to be any shortage of mainstream policy makers/influencers saying the elderly are getting too much treatment.
There are very few of us pointing out that *undertreatment*, based on a “value of life” judgment is also a problem – probably a growing one – in terms of denial of health care for the elderly and people with significant disabilities.
Yes, UNDER TREATMENT of the elderly/disabled is driven by reimbursement protocols that so often mean that the hospital/physician will not be reimbursed by CMS for errors, omissions, over treatment and complications. The right to die and the right to live, as implied in the 1991 Patient Self Determination Act has been circumvented since its inception, as to both choices.
The States have interpreted the PSDA in many different ways and the CONGRESS refuses to clarify the PSDA. We now have some States clarifying the PSDA to protect the elderly/disabled from unilateral DNRs but we have many other states who have done NOTHING. .
Obviously, since “medical futility” has to be defined very narrowly under law, when defined, and because physicians in the outpatient and the in0patient setting don’t have to SEEK informed consent for either Curative Care or Palliative Care, physicians can OVER TREAT patients and be reimbursed up to the Diagnosis Related Group Cap (DRG Cap)
But when the DRG Cap is exceeded, hospitals/physicians are inappropriately and illegally extrapolating DNR Code Status into the charts of elderly/disabled Medicare/Medicaid patients in order to limit life-extending and life-saving treatments that they KNOW will not be reimbursed by CMS and the private insurers because the DRG Cap has been exceeded and/or there have been errors/omissions and non beneficial treatments and complications.
This may be epidemic NOW because the bioethicists have failed to warn and to look at the relationship between medical futility and fiscal futility and non-beneficial over treatments, and turn their heads the other way while hospitals and physicians unilaterally illegally shorten the lives of the elderly/disabled with impunity under existing laws.
NOW I read in the Medical Futility Blog that States like California have passed new laws that enable POLST (physician orders for life-sustaining treatment) that permit DNR Code Status to be part of the POLST WITHOUT the INFORMED CONSENT of the patient!
While the federal/state laws law appears to indicate that unilateral shortening of life is only legal when the patient wants to do the shortening, or when “medical futility” is proven by the hospital in a due process procedure, this bold move to legalize unilateral DNRs in the POLST document is frightening.
How can this be? How can this be stopped when it is so easy to place oral covert and overt DNR Code Status into the medical charts of the elderly. There are NO PROCEDURAL PROTECTIONS for the elderly/disabled against oral and un-witnessed (by anybody) overt and covert unilateral DNRs used as the default status in the medical charts of the elderly/disabled.
Obviously, this is intentional but not illegal?